How should a laryngeal mask be inserted?

The proper insertion of a laryngeal mask airway (LMA) is critical for ensuring effective ventilation and airway management in unconscious or anesthetized patients. The technique involves inserting the LMA with the upper surface (the cuffed part) applied to the palate. This angle of insertion aligns the device with the anatomy of the oropharynx, facilitating proper placement over the laryngeal opening.

By inserting the LMA in this manner, you help ensure the cuff expands in a way that seals the airway effectively, preventing air leaks during ventilation. This technique also minimizes the risk of trauma to the oral cavity and surrounding structures, as it requires a smooth, controlled motion that follows the natural contours of the throat.

In contrast, other methods of insertion either do not align the LMA correctly for optimal placement or could increase the risk of complications. For example, inserting with the cuff facing the tongue may misplace the device, while horizontal insertion might fail to navigate the anatomical curves of the oropharynx effectively. Attempting to insert the LMA when the patient is fully conscious is also counterproductive, as it can provoke gagging and discomfort, impeding correct placement and potentially leading to airway obstruction.